The parallel process in clinical supervision with a schizophrenic client

The authors analyze a male nurse's account of how he experienced his interaction with a female schizophrenic client during sessions of systematic clinical supervision. Notes taken during 15 sessions were analyzed by means of open coding. The analysis revealed the importance of being aware of the parallel process that occurs among the client, the primary nurse, and the unit staff.     

Designing flexibility into memory systems

This paper describes two techniques which can be used to improve the flexibility of modern microcomputer systems. The first is the idea of a ‘processor-configured’ system, whereby the memory and peripheral interfaces may have their structure logically altered by a single from the processor card, so that they match the wordlength of the processor used. The technique may be applied to existing bus standards with a minimum of modification, and then allows 8-bit and 16-bit processor cards to be exchanged on the system with a minimum of inconvenience, and without compromising performance. The second technique, of ‘shadow-ROM’, is not new, but is not yet widely used in personal computer systems. The system described, using most significant address page switching, is a particularly flexible one.     

Iodine-131-anti-B1 radioimmunotherapy for B-cell lymphoma

PURPOSE: The CD20 B-lymphocyte surface antigen expressed by B-cell lymphomas is an attractive target for radioimmunotherapy, treatment using radiolabeled antibodies. We conducted a phase I dose-escalation trial to assess the toxicity, tumor targeting, and efficacy of nonmyeloablative doses of an anti-CD20 monoclonal antibody (anti-B1) labeled with iodine-131 (131I) in 34 patients with B-cell lymphoma who had failed chemotherapy. PATIENTS AND METHODS: Patients were first given tracelabeled doses of 131I-labeled anti-B1 (15 to 20 mg, 5 mCi) to assess radiolabeled antibody biodistribution, and then a radioimmunotherapeutic dose (15 to 20 mg) labeled with a quantity of 131I that would deliver a specified centigray dose of whole-body radiation predicted by the tracer dose. Whole-body radiation doses were escalated from 25 to 85 cGy in sequential groups of patients in 10-cGy increments. To evaluate if radiolabeled antibody biodistribution could be optimized, initial patients were given one or two additional tracer doses on successive weeks, each dose preceded by an infusion of 135 mg of unlabeled anti-B1 one week and 685 mg the next. The unlabeled antibody dose resulting in the most optimal tracer biodistribution was also given before the radioimmunotherapeutic dose. Later patients were given a single tracer dose and radioimmunotherapeutic dose preceded by infusion of 685 mg of unlabeled anti-B1. RESULTS: Treatment was well tolerated. Hematologic toxicity was dose-limiting, and 75 cGy was established as the maximally tolerated whole-body radiation dose. Twenty-eight patients received radioimmunotherapeutic doses of 34 to 161 mCi, resulting in complete remission in 14 patients and a partial response in eight. All 13 patients with low-grade lymphoma responded, and 10 achieved a complete remission. Six of eight patients with transformed lymphoma responded. Thirteen of 19 patients whose disease was resistant to their last course of chemotherapy and all patients with chemotherapy-sensitive disease responded. The median duration of complete remission exceeds 16.5 months. Six patients remain in complete remission 16 to 31 months after treatment. CONCLUSION: Nonmyeloablative radioimmunotherapy with 131I-anti-B1 is associated with a high rate of durable remissions in patients with B-cell lymphoma refractory to chemotherapy.     

Respiratory electromyographic estimates of ventilatory functions in piglets

The best electromyographic (EMG) predictors of respiratory drive (P100), tidal volume (VT) and ventilation (VE) were determined from diaphragmatic (DI) and posterior cricoarytenoid (PCA) EMG measures in 8-48-day-old, anesthetized piglets. Progressive hypercapnia was employed to obtain a wide range of muscle activity. A custom-designed, microcomputer-based system was employed to measure the duration, peak amplitude, rate of rise (initial slope) as well as the summed total and initial (first 100 ms) EMG activity from the DI and the PCA. For each respiratory function, the following combinations of EMG measures were identified as significant predictors using regression analyses: (1) for P100, DI amplitude, PCA initial area and PCA rate of rise; (2) for VT, DI amplitude, PCA duration and DI duration; (3) for VE, DI amplitude, DI initial area, PCA initial area, PCA rate of rise, PCA duration, DI area and DI rate of rise. Thus, whereas the traditionally employed measure of DI amplitude is an important correlate of P100, VT or VE, a complete estimate of these respiratory functions requires the inclusion of initial EMG measures and duration.     

Serum enzyme activities in the African elephant (loxodonta africana)

The serum activities of aspartate aminotransferase, alanine aminotransferase, alpha-hydroxybutyrate dehydrogenase and creatine phosphokinase have been measured in the African elephant. In general, the values were broadly comparable with those of man except that alanine aminotransferase was much lower and creatine phosphokinase higher. No variation due to age, sex, season or location was observed.     

Morphologic disturbance of lung maturation in fetuses of alloxan diabetic rabbits

Maturation of lungs was studied morphologically in fetuses of does made diabetic with alloxan. The lungs of fetuses of does treated with alloxan 24 h after mating appeared to be less mature than control lungs, as shown by significant decrease in areal density of air space (p < 0.01) and by increases in areal density of alveolar epithelium and capillaries (p < 0.02). In alloxan fetuses, ultrastructural techniques revealed that type II cells had 10 times the control value for areal density of glycogen (p < 0.01) and 2.5 times that of rough endoplasmic reticulum (p < 0.05), but the proportion of type II cells and the number of lamellar bodies per type II cell profile were similar in both groups. Ultrastructural examination of capillaries demonstrated that their migration and the fusion of their basement membrane with that of alveolar epithelium did not occur as frequently in alloxan fetuses as in control fetuses. Biochemically, the lungs of alloxan fetuses contained significantly more glycogen and protein (p < 0.01) than control lungs, but the deoxyribonucleic acid was similar. The alloxan fetuses had a disturbance of lung structural maturation that was consistent with our previous findings of delayed functional maturation without accompanying change in disaturated phosphatidylcholine levels and ratio of lecithin to sphingomyelin.     

Bases of surgical treatment of bilateral suppurative processes in the lungs

In dogs subjected to gravitational overloadings (+Gx) according to a special training schedule the wall structure of the main arteries (carotid, humeral, femoral and aorta) was studied by histological methods. The amount of catecholamines (adrenaline and noradrenaline) in the venous blood plasma and in the adrenal tissue was the index of the sympathoadrenal system condition. It was demonstrated that in trained animals the tolerance threshold to continuously increasing overloadings (+Gx) rose. It was accompanied by an elevated amount of catecholamines in blood and the adrenals In the walls of the main arteries studied a moderate hyperelastosis and a slight collagenization of the adventitia was noted. All parts of the microcirculatory bed were moderately dilated, which favoured a better blood outflow. The data obtained demonstrate adaptational changes, which can be interpreted as indices of training and reliability of the organism.     

Teratogenic and embryotoxic activity of several 2,4-diaminopyrimidine derivatives

The degree of teratogenic and embryotoxic effects is dependent not only on the period of gestation and the agent dosage but also on the chemical structure of its molecule. In the series of derivatives of 2,4-diamino-5-phenylpyrimidine with different length of the alkul radical in the 6 position the preparation with ethyl group has the greatest injuring effect. Thus, the structural distinctions in the molecules of pharmacological agents are responsible for the selective toxicity of drugs in relation to mammalian embryos.